流感与其他呼吸道病毒——评估住院儿童的严重程度，比利时，2011 年至 2020 年
2023/07/25
摘要
有关比利时因严重急性呼吸道感染（SARI）住院的儿童中流感病毒与其他呼吸道病毒造成的负担的知识十分有限。通过多重实时定量 PCR（RT-qPCR）对 2011 年至 2020 年冬季采集的呼吸道标本进行了流感和其他呼吸道病毒检测。通过问卷调查收集了人口统计学数据和风险因素。对住院期间出现并发症或死亡的患者进行随访。分析的重点是 15 岁以下的儿童。结果在2011年至2020年的冬季，有2944份标本符合研究病例的定义。并发症在有潜在风险因素的儿童中更为常见，尤其是哮喘（调整风险比 (aRR)：1.87；95% 置信区间 (CI)：1.46-2.30）和慢性呼吸道疾病（aRR：1.88；95% CI：1.44-2.32），与感染状况和年龄无关。与仅感染流感的儿童相比，感染非流感呼吸道病毒的儿童出现并发症的风险高出 32%（aRR：1.32；95% CI：1.06-1.66）。无论病毒检测结果和年龄如何，患有哮喘和呼吸道疾病的儿童都应优先得到临床护理，并成为预防活动的目标。
Influenza versus other respiratory viruses - assessing severity among hospitalised children, Belgium, 2011 to 2020
Fischer, N., Moreels, S., Dauby, N., Reynders, M., Petit, E., Gérard, M., Lacor, P., Daelemans, S., Lissoir, B., Holemans, X., Magerman, K., Jouck, D., Bourgeois, M., Delaere, B., Quoilin, S., Van Gucht, S., Thomas, I., Bossuyt, N., & Barbezange, C.
ABSTRACT
BackgroundKnowledge on the burden attributed to influenza viruses vs other respiratory viruses in children hospitalised with severe acute respiratory infections (SARI) in Belgium is limited.AimThis observational study aimed at describing the epidemiology and assessing risk factors for severe disease.MethodsWe retrospectively analysed data from routine national sentinel SARI surveillance in Belgium. Respiratory specimens collected during winter seasons 2011 to 2020 were tested by multiplex real-time quantitative PCR (RT-qPCR) for influenza and other respiratory viruses. Demographic data and risk factors were collected through questionnaires. Patients were followed-up for complications or death during hospital stay. Analysis focused on children younger than 15 years. Binomial logistic regression was used to identify risk factors for severe disease in relation to infection status.ResultsDuring the winter seasons 2011 to 2020, 2,944 specimens met the study case definition. Complications were more common in children with underlying risk factors, especially asthma (adjusted risk ratio (aRR): 1.87; 95% confidence interval (CI): 1.46-2.30) and chronic respiratory disease (aRR: 1.88; 95% CI: 1.44-2.32), regardless of infection status and age. Children infected with non-influenza respiratory viruses had a 32% higher risk of complications (aRR: 1.32; 95% CI: 1.06-1.66) compared with children with influenza only.ConclusionMulti-virus testing in children with SARI allows a more accurate assessment of the risk of complications and attribution of burden to respiratory viruses beyond influenza. Children with asthma and respiratory disease should be prioritised for clinical care, regardless of their virological test result and age, and targeted for prevention campaigns.
有关比利时因严重急性呼吸道感染（SARI）住院的儿童中流感病毒与其他呼吸道病毒造成的负担的知识十分有限。通过多重实时定量 PCR（RT-qPCR）对 2011 年至 2020 年冬季采集的呼吸道标本进行了流感和其他呼吸道病毒检测。通过问卷调查收集了人口统计学数据和风险因素。对住院期间出现并发症或死亡的患者进行随访。分析的重点是 15 岁以下的儿童。结果在2011年至2020年的冬季，有2944份标本符合研究病例的定义。并发症在有潜在风险因素的儿童中更为常见，尤其是哮喘（调整风险比 (aRR)：1.87；95% 置信区间 (CI)：1.46-2.30）和慢性呼吸道疾病（aRR：1.88；95% CI：1.44-2.32），与感染状况和年龄无关。与仅感染流感的儿童相比，感染非流感呼吸道病毒的儿童出现并发症的风险高出 32%（aRR：1.32；95% CI：1.06-1.66）。无论病毒检测结果和年龄如何，患有哮喘和呼吸道疾病的儿童都应优先得到临床护理，并成为预防活动的目标。
(中日友好医院呼吸与危重症医学科 沈焜路 摘译 林江涛 审校)
(Euro Surveill. 2023 Jul; DOI: 10.2807/1560-7917.ES.2023.28.29.2300056)
(Euro Surveill. 2023 Jul; DOI: 10.2807/1560-7917.ES.2023.28.29.2300056)
Influenza versus other respiratory viruses - assessing severity among hospitalised children, Belgium, 2011 to 2020
Fischer, N., Moreels, S., Dauby, N., Reynders, M., Petit, E., Gérard, M., Lacor, P., Daelemans, S., Lissoir, B., Holemans, X., Magerman, K., Jouck, D., Bourgeois, M., Delaere, B., Quoilin, S., Van Gucht, S., Thomas, I., Bossuyt, N., & Barbezange, C.
ABSTRACT
BackgroundKnowledge on the burden attributed to influenza viruses vs other respiratory viruses in children hospitalised with severe acute respiratory infections (SARI) in Belgium is limited.AimThis observational study aimed at describing the epidemiology and assessing risk factors for severe disease.MethodsWe retrospectively analysed data from routine national sentinel SARI surveillance in Belgium. Respiratory specimens collected during winter seasons 2011 to 2020 were tested by multiplex real-time quantitative PCR (RT-qPCR) for influenza and other respiratory viruses. Demographic data and risk factors were collected through questionnaires. Patients were followed-up for complications or death during hospital stay. Analysis focused on children younger than 15 years. Binomial logistic regression was used to identify risk factors for severe disease in relation to infection status.ResultsDuring the winter seasons 2011 to 2020, 2,944 specimens met the study case definition. Complications were more common in children with underlying risk factors, especially asthma (adjusted risk ratio (aRR): 1.87; 95% confidence interval (CI): 1.46-2.30) and chronic respiratory disease (aRR: 1.88; 95% CI: 1.44-2.32), regardless of infection status and age. Children infected with non-influenza respiratory viruses had a 32% higher risk of complications (aRR: 1.32; 95% CI: 1.06-1.66) compared with children with influenza only.ConclusionMulti-virus testing in children with SARI allows a more accurate assessment of the risk of complications and attribution of burden to respiratory viruses beyond influenza. Children with asthma and respiratory disease should be prioritised for clinical care, regardless of their virological test result and age, and targeted for prevention campaigns.
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